不扩髓交锁髓内钉固定治疗肱骨干粉碎性骨折的临床研究

目的探索应用不扩髓髓内钉固定治疗肱骨干粉碎性骨折的临床效果。方法通过对本院收治的17例肱骨干粉碎性骨折,采用不扩髓交锁髓内钉固定治疗后临床效果的回顾性分析,综合评估该方法对肱骨干粉碎性骨折治疗的可行性。结果按Winquist骨折分类法,17例患者中,Ⅰ型1例,Ⅱ型5例,Ⅲ型8例,Ⅳ型3例。多发性损伤12例(ISS≥20)。1例发生不完全性脂肪栓塞。6例为开放性骨折急诊手术。术后45 d骨折处大量骨痂生长者12例,90 d 5例。14例90 d骨折线完全消失,3例120 d完全消失(均为Ⅲ型,Ⅳ型骨折)。所有病例术后12￣24个月拔出髓内钉。远期疗效优14例,良3例。未发现断钉、骨不连、畸形愈合、取钉后再骨折等并发症,也未发生正中神经,桡神经,尺神经等损伤。结论应用不扩髓髓内钉固定法治疗肱骨干粉碎性骨折效果良好,可在临床上推广。

Clinical study of femoral shaft comminuted fracture treated with unexpanded interlockingbone nail

Objective To explore the clinical effect of femoral shaft comminuted fracture cured by unexpanded interlocking bone nail.Methods Retrospective analysis was carried on 17 patients with femoral shaft comminuted fracture cured by unexpanded interlocking bone nail,and estimated the effect of the methods.Results Bone nail were pulled out after 12~24 m,14 cases were excellent prostecdtive efficacy,and 3 cases were well.There was no complication occurred.Conclusion There is a good curative effect applying unexpanded interlocking bone nail to cure femoral shaft comminuted fracture,and it can be extended in clinic.